Eugene Orlando Gardner, LCSW-R

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

R0300131 Issued in NY

Practice address

5 Hemphill Place
Suite 121
Malta, NY 12020-4423

Phone

(518) 289-5072

Fax

(518) 289-5225

NPI assigned

Nov 2, 2005

Last updated

Aug 30, 2023By the provider in NPPES

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Union Street Counseling Services, LLC

  • Community/Behavioral Health Agency
  • Malta, NY
  • NPI 1215129325
  NPD
• Psychological Services

  • Psychologist
  • Saratoga Springs, NY
  • NPI 1790972834
  NPD (past)
• Union Counseling Services, PLLC

  • Mental Health Counselor
  • Schenectady, NY
  • NPI 1851514384
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1130889600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693353600000",
    "number": "1063403772",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5 HEMPHILL PLACE",
            "address_2": "SUITE 121",
            "city": "MALTA",
            "state": "NY",
            "postal_code": "120204423",
            "telephone_number": "518-289-5072",
            "fax_number": "518-289-5225"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5 HEMPHILL PLACE",
            "address_2": "SUITE 121",
            "city": "MALTA",
            "state": "NY",
            "postal_code": "120204423",
            "telephone_number": "518-289-5072",
            "fax_number": "518-289-5225"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GARDNER",
        "first_name": "EUGENE",
        "middle_name": "ORLANDO",
        "name_prefix": "Mr.",
        "credential": "LCSW-R",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-02",
        "last_updated": "2023-08-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "R0300131",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dana Calabrese Fox, FNP
• Jason K Funk, RPH
• Furniture Theatre Inc.
• Andrew Joseph Gaetano, PT, DPT, OCS, CSCS
• Allison Gammon, M.S., BCBA
• Haley Marie Gatti, RN
• Martha Y Geleta, RPH
• Brittany Glenn
• Maryanne Godlewski, RPH
• Jessalyn Goetz, PT, DPT

• Clinical Social Worker in Malta, NY
• Providers in Malta, NY by specialty
• Clinical Social Worker in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.